The results of the past decade of value-based payment (VBP) model implementation have provided mixed evidence of the impacts of these reforms, and questions about how payment and care reforms can best improve quality, outcomes, and the care experiences of patients. The years of reform experience, recent trends, plus a new Administration that has expressed a commitment to effective payment reform have led to a number of thoughtful assessments of how to proceed from here. In a two-part post, we reflect on “lessons learned” from the evidence gained from the past decade and beyond to promote the effectiveness of APMs. We describe the implications for future VBP efforts and the implications for the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI).
As Exhibit 1 summarizes, these lessons span the development, implementation, and maturity and refinement of VBP models. In part 1 of this post, we discussed lessons concerning the development and implementation of VBP models. Here, part 2 discusses lessons regarding the refinement and expansion of VBP models, which are crucial to achieving system-wide transformation. We also summarize the key themes of the past decade of payment reform experience and emphasize the importance of building off these lessons.
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Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Senior Team Member
Margolis Core Faculty
Director of Margolis Center
Robert J. Margolis, MD, Professor of Business, Medicine and Policy
Margolis Executive Core Faculty